tetano
Editor, Senior Moderator
Infect Control Hosp Epidemiol
. 2021 Apr 15;1-28.
doi: 10.1017/ice.2021.167. Online ahead of print.
Health Care Acquired COVID-19 is Less Symptomatic than Community Acquired Disease Among Healthcare Workers
Jeffrey J Fletcher[SUP] 1 2 [/SUP], Eric C Feucht[SUP] 1 [/SUP], Peter Y Hahn[SUP] 1 [/SUP], Theresa N McGoff[SUP] 3 [/SUP], Del J Dehart[SUP] 4 [/SUP], Mohamad E El Mortada[SUP] 4 [/SUP], Ronald G Grifka[SUP] 3 [/SUP]
Affiliations
Abstract
Objective: We hypothesized healthcare workers (HCW) with high-risk exposures outside the healthcare system would have less asymptomatic coronavirus 2019 (COVID-19) disease and more symptoms than those without such exposures.
Design: A longitudinal point prevalence study during August 17- September 4 2020 and December 2nd - 23rd.
Setting: Community based teaching health system.
Participants: All HCS were invited to participate. Among HCW who acquired COVID-19, logistic regression models were used to evaluate the adjusted odds of asymptomatic disease using high-risk exposure outside the healthcare system as the explanatory variable. The number of symptoms between exposure groups was evaluated with the Wilcoxon rank-sum test. The risk of seropositivity among all HCS by work exposure was evaluated during both periods.
Interventions: Survey and serological testing.
Result: Seroprevalence increased from 1.9% (95% CI 1.2% - 2.6%) to 13.7% (95% CI 11.9% - 15.5%) during the study. Only during Period 2 did HCW with the highest work exposure (versus low exposure) have an increased risk of seropositivity (RD 7% [95% CI 1% -13%]). Participants who had a high-risk exposure outside of work (compared to those without) had a decreased probability of asymptomatic disease (OR 0.38 [95% CI 0.16 - 0.86]) and demonstrated more symptoms (median of 3 [IQR 5] vs 1 [IQR 2]; P = 0.001).
Conclusions: Health care acquired COVID-19 increases the probability of asymptomatic or mild COVID-19 disease compared to community acquired disease. This suggests infection prevention strategies (including masks and eye protection) may be mitigating inoculum and supports the variolation theory in COVID-19.
Keywords: COVID-19; SARS-CoV-2; Seroprevalence; antibody; asymptotic COVID-19.
. 2021 Apr 15;1-28.
doi: 10.1017/ice.2021.167. Online ahead of print.
Health Care Acquired COVID-19 is Less Symptomatic than Community Acquired Disease Among Healthcare Workers
Jeffrey J Fletcher[SUP] 1 2 [/SUP], Eric C Feucht[SUP] 1 [/SUP], Peter Y Hahn[SUP] 1 [/SUP], Theresa N McGoff[SUP] 3 [/SUP], Del J Dehart[SUP] 4 [/SUP], Mohamad E El Mortada[SUP] 4 [/SUP], Ronald G Grifka[SUP] 3 [/SUP]
Affiliations
- PMID: 33853694
- DOI: 10.1017/ice.2021.167
Abstract
Objective: We hypothesized healthcare workers (HCW) with high-risk exposures outside the healthcare system would have less asymptomatic coronavirus 2019 (COVID-19) disease and more symptoms than those without such exposures.
Design: A longitudinal point prevalence study during August 17- September 4 2020 and December 2nd - 23rd.
Setting: Community based teaching health system.
Participants: All HCS were invited to participate. Among HCW who acquired COVID-19, logistic regression models were used to evaluate the adjusted odds of asymptomatic disease using high-risk exposure outside the healthcare system as the explanatory variable. The number of symptoms between exposure groups was evaluated with the Wilcoxon rank-sum test. The risk of seropositivity among all HCS by work exposure was evaluated during both periods.
Interventions: Survey and serological testing.
Result: Seroprevalence increased from 1.9% (95% CI 1.2% - 2.6%) to 13.7% (95% CI 11.9% - 15.5%) during the study. Only during Period 2 did HCW with the highest work exposure (versus low exposure) have an increased risk of seropositivity (RD 7% [95% CI 1% -13%]). Participants who had a high-risk exposure outside of work (compared to those without) had a decreased probability of asymptomatic disease (OR 0.38 [95% CI 0.16 - 0.86]) and demonstrated more symptoms (median of 3 [IQR 5] vs 1 [IQR 2]; P = 0.001).
Conclusions: Health care acquired COVID-19 increases the probability of asymptomatic or mild COVID-19 disease compared to community acquired disease. This suggests infection prevention strategies (including masks and eye protection) may be mitigating inoculum and supports the variolation theory in COVID-19.
Keywords: COVID-19; SARS-CoV-2; Seroprevalence; antibody; asymptotic COVID-19.